Across the South, Republican governors and state legislatures have turned down federal funding to expand Medicaid, excluding millions of uninsured, working-poor residents from health care coverage -- and missing an opportunity to shift costs away from expensive emergency-room care.

One of the biggest decisions facing North Carolina's new legislature and governor is whether to expand Medicaid under the Affordable Care Act to cover more than 500,000 low-income people. Much of the opposition to expansion is more about ideology than anything else, a visceral reaction to a law that has been mischaracterized since it was proposed.

Southern states have among the highest rates of uninsured residents. They also have state officials who are among the most vocal critics of the Supreme Court's decision upholding the Affordable Care Act.